By William Doolittle
For the Messenger
Monroe County residents, because of their deep
concern over soaring school populations and the
resulting property tax increases, need to understand
the broad context in which school funding occurs.
Peering back to the nation’s beginning, the Founding
Fathers, in their wisdom, understood that in this
large, new land one size would not fit all when it
came to education.
As a result the founders made no specific mention of
national control, or funding, of education even though
they understood education was absolutely necessary
in a democracy that needs an educated electorate.
These men who were educated at home or in tiny schoolhouses down the lane left the running of schools to
the states.
The Tenth Amendment of the Bill of Rights states,
“The powers not delegated to the United States by the
Constitution, nor prohibited by it to the states, are
reserved to the states respectively, or to the
people.”
That is the only guidance given to the citizens of
the United States about who is to run their schools.
In a back-handed manner, the Tenth Amendment reserves the
power and responsibility of public education systems
exclusively to the states, by not enumerating that
responsibility to the federal government.
But, you may exclaim, “My local school board runs the
schools.” That is true, but only at the sufferance of
the states, which have gingerly turned many function s
of school operations to local school boards.
Hawaii runs a single statewide school system. To
further prove the point that the states are, by law ,
in charge, there have been several instances in the
past decade when the state took over entire school
systems, among them Philadelphia, Newark and Jersey
City.
Through the years, hard-pressed citizens have
complained that several state methods of distributing
so-called state aid to local districts is unfair
because affluent districts are able to draw more money
per student from property owners than poorer
districts.
This is the downside of state control,
because many legislatures are unable to, or unwilling
to respond adequately to special situations such a s
fast growth.
According to the state Department of Education,
“Pennsylvania’s school districts receive 57 percent of
their revenues from local sources and 38 percent from
the state. The state provides about 25 percent of
(local) general fund budget.”
This is one of the lowest rates in the United States,
a disgraceful performance, placing Pennsylvania on a
level with the poorest states in the union. If the
state provided 50 percent or more of the operating
budget of local schools, the school property taxes
might be mitigated.
According to a recent study by the
Pew Charitable Trusts, Pennsylvania placed 49th of the
50 states in the state contribution to local school
operating budgets.
Another misconception is that the federal government
plays a major role in funding education. Not so. The
federal government is a minor contributor to local
school education funding.
After all is said and done, state legislators are
completely responsible for educating our children,
even though the state has “loaned” much of that
responsibility to local school boards.
Examine for yourselves their poor performance and ask yourselves why
these people care so little about your child’s education.
Sunday, October 5, 2008
How PMC's ER fixed serious problem
By William Doolittle
For the Messenger
The Pocono Medical Center's emergency room suffered serious problems in the past and a detailed study outlines the successful steps taken to cure them.
The study, published in Health Management Technology, in April of 2006 said, PMC “struggled with high bed occupancy and surges in patient volume, six-hour wait times in the emergency department (ED), as well as other problems such as “lost” charts, poor documentation and low patient satisfaction.
The study of PMC’s situation noted “Also, it was hard to miss.. . . scores on patient satisfaction, which averaged 20 percent, reflecting that 80 percent of other hospitals did a better job pleasing ED patients.”
After the emergency room completed automating, the patient satisfaction scores reversed, with 80 percent patient approval.
Before it was automated, the emergency department treated 50,000 patients a year using mostly a paper tracking and registration system. Now, more than 70,000 patients a year visit the ER.
The story points out that the situation was so serious that in 2001 hospital officials began to study an automated information system for the ER.
“For starters, triage or patient screening took at least an hour, which was too long, especially with chest pain patients. Long wait times not only put patients at risk, but also posed a public relations problem for the hospital,” the magazine reports.
“The hospital needed information from patients to get them registered and to track them, but this required a lot of time and created the mistaken impression that the hospital was focused more on insurance information and medical record numbers than on patient care,” the study found. “The Waiting Room Is Closed” was the name of the new policy of speeding patients through the admission process and into the ER itself for treatment.
The results were amazing.
Data from the system supplied baseline numbers of how to improve the operation, including:
The emergency department at PMC now handles more than 70,000 visits a year, and although many patients may still disagree, it appears as if the ER has gone a long way toward solving its "satisfaction" problems.
For the Messenger
The Pocono Medical Center's emergency room suffered serious problems in the past and a detailed study outlines the successful steps taken to cure them.
The study, published in Health Management Technology, in April of 2006 said, PMC “struggled with high bed occupancy and surges in patient volume, six-hour wait times in the emergency department (ED), as well as other problems such as “lost” charts, poor documentation and low patient satisfaction.
The study of PMC’s situation noted “Also, it was hard to miss.. . . scores on patient satisfaction, which averaged 20 percent, reflecting that 80 percent of other hospitals did a better job pleasing ED patients.”
After the emergency room completed automating, the patient satisfaction scores reversed, with 80 percent patient approval.
Before it was automated, the emergency department treated 50,000 patients a year using mostly a paper tracking and registration system. Now, more than 70,000 patients a year visit the ER.
The story points out that the situation was so serious that in 2001 hospital officials began to study an automated information system for the ER.
“For starters, triage or patient screening took at least an hour, which was too long, especially with chest pain patients. Long wait times not only put patients at risk, but also posed a public relations problem for the hospital,” the magazine reports.
“The hospital needed information from patients to get them registered and to track them, but this required a lot of time and created the mistaken impression that the hospital was focused more on insurance information and medical record numbers than on patient care,” the study found. “The Waiting Room Is Closed” was the name of the new policy of speeding patients through the admission process and into the ER itself for treatment.
The results were amazing.
Data from the system supplied baseline numbers of how to improve the operation, including:
- Improved patient length of stay; more than 50 percent of patients were in the ED more than four hours.
- Eliminate lost charts; physicians estimated that 4 percent were “lost” and no bill was issued.
- Retain more nurses; they used an average of 23 percent agency nurses because of staffing shortages.
The emergency department at PMC now handles more than 70,000 visits a year, and although many patients may still disagree, it appears as if the ER has gone a long way toward solving its "satisfaction" problems.
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